Purchasing Contact

Accounts Payable Contact

Company Information

Does this company have a Tax Exempt Resale Certificate or Special Purpose Tax Exemption Certificate?

Yes
No

Has this company ever filed for bankruptcy?

Yes
No

Is company or parent company publicly traded?

Yes
No

Principals/Officers/Key Managers

Principal 1

Name *

Title *

Phone *

Principal 2

Name

Title

Phone

Principal 3

Name

Title

Phone

Principal 4

Name

Title

Phone

References

Would you prefer to upload you information?

Yes
No

Bank Information

Bank Name *

Bank Contact *

Bank City *

Bank Phone *

Bank Fax *

Trade Reference 1

Company *

Contact *

Email *

City *

Phone *

Fax

Trade Reference 2

Company *

Contact *

Email *

City *

Phone *

Fax

Trade Reference 3

Company *

Contact *

Email *

City *

Phone *

Fax

Product information

Product(s)

Volume/Quantity (Estimate)

Requested Credit Limit *

Lintech Sales Representative

Total Annual Anticipated Purchase *

Is there an order pending with this application?

Yes
No

Terms and Conditions

This is an application and agreement for credit and shall apply to any and all credit extended by Lintech International. The credit applicant understands and agrees to the following terms of sale:

Terms of the sale are Net 30 days terms and require approval by Credit Manager. Agents or representatives of Lintech International are not authorized to change or adjust credit terms without written authorization of management.

All claims against invoices must be made within 10 days after reciept of goods.

Goods may not be returned without prior authorization of Lintech International.

Goods/merchandise authorized for return will be subject to a minimum of 25% restocking charge.

NSF checks will be subject to a $35.00 charge.

Failure to comply with these terms and conditions may result in cancellation of credit privileges without notice.

In the event any collection efforts or legal proceedings are instituted on customer account, customer will be responsible for payment of all reasonable expenses incurred in collection of the claim including reasonable attorney, fees and court costs. Late or delinquent payments shall be subject to an interest rate of 1 ½% per month from due date until paid.

In no event shall Lintech be liable for indirect, in credential, special, consequential or other damages, suffered by Customer or any other part for lost profit, sales, labor, injury to person (s) or property or any other loss unless otherwise contractually specified.

The information in this application is warranted to be true and correct and given for the purpose of obtaining credit.

The applicant consents to the obtaining of credit information as may be required in connection with the credit line herby applied for or any renewal or extension thereof and to the disclosure of any trade information concerning the applicant to any credit reporting agency and others who may lawfully receive such information.

Authorized Person's Name *

By typing your name above, you agree that all information is accurate to the best of your knowledge.